EP3849462A1

EP3849462A1 - One-piece wound healing element

Info

Publication number: EP3849462A1
Application number: EP19768771.8A
Authority: EP
Inventors: Cédric LANCIEUX; Benjamin CALVAT; Théo LEGER
Original assignee: Euroteknika SAS
Current assignee: Euroteknika SAS
Priority date: 2018-09-14
Filing date: 2019-09-10
Publication date: 2021-07-21
Anticipated expiration: 2039-09-10
Also published as: ES2970991T3; FR3085833B1; MA53593A; EP3849462C0; FR3085833A1; EP3849462B1; WO2020053229A1; MA53593B1

Abstract

The invention relates to a one-piece wound healing element (10), characterised in that it comprises: - an implant portion (12) suitable for attachment to a dental implant (60), at least a lower portion of which is orientated along a first axis (A1), - a crown portion (11) intended for incorporation within a gum (3) in order to shape the gum (3) during healing thereof, at least an upper portion of which extends generally along a second axis (A2) and characterised in that the first axis (A1) and the second axis (A2) form a first non-zero angle (α).

Description

One-piece healing element

Technical field of the invention

The present invention relates to a healing element intended to be fixed to a dental implant. It also relates to a dental restoration set comprising such a healing element and an implant. Finally, it also relates to a dental restoration process.

State of the art

Dental restoration makes it possible to provide artificial dentition to a partially or totally toothless patient. It is based on the integration of one or more implants in the bone structure, made by an incision of the gum in order to reach the bone structure and pierce it. Then, a healing element is generally fixed on an implant and this assembly remains untouched until the implant is secured in the bone structure by osseointegration and healing of the gum around the healing element. Dental restoration can be finalized by attaching a restoration abutment to the implant, on which the dental prosthesis is fixed. The abutment and the dental prosthesis are personalized, adapted to the patient's anatomy and the tooth to be replaced, to achieve a result as close as possible to the ideal natural dentition. For this, the precise volume of the space to be restored is generally taken into account, by taking an impression, which allows the personalized manufacture of the dental prosthesis.

In the prior art, existing methods of dental restoration encounter all or part of the following technical problems: - in many existing procedures, a new intervention on the gum is carried out after its healing following the implant break, to make the impression, material or digital, of the space to be restored, while having a view of the implant and gum to take into account precisely all of this geometry, in order to manufacture a pillar and a prosthesis of precise shapes: this approach is naturally traumatic;

- other existing methods limit this trauma by using healing components which are not removed during an impression, in order not to strike the gum: in return, these methods use specific healing elements, in general of substantially cylindrical and standard shape and sometimes incorporating indicators and / or several complementary components to allow taking into account all or part of the geometry above the implant without having full access by taking an impression. These less traumatic methods then have other drawbacks, of complexity and / or less good optimization of the healing phase;

- the existing dental restoration elements offer a low flexibility of appearance, and / or positioning, and / or orientation compared to the neighboring teeth. During the transitional period, which precedes the final restoration with a prosthesis fixed on the implant, the aesthetic aspect is thus often neglected. In addition, a bad positioning and / or a bad orientation can induce important mechanical stresses in the structure bone and in the gum during healing. Such constraints can be painful and slow healing; - the restoration abutment and the dental prosthesis are aligned with the implant; the latter must therefore be positioned along the axis defined by the dentition to be restored, that is to say the axis of the dental prosthesis. This approach has the drawback of the lack of flexibility in positioning the implant in the bone structure. If the latter is insufficient at the location required for the implant, a prior bone graft must be performed, which induces additional surgical heaviness, detrimental to the patient.

Subject of the invention

Thus, a general object of the invention consists of a healing element which does not include all or part of the drawbacks of the state of the art.

More specifically, a first object of the invention is a dental restoration solution which minimizes the trauma of the patient during the restoration process.

A second object of the invention is a dental restoration solution which allows restoration that is as suitable as possible for the patient's anatomy. A third object of the invention is the simplest possible dental restoration solution. A fourth object of the invention is a dental restoration solution making it possible to achieve an optimal aesthetic appearance.

A fifth object of the invention is a dental restoration solution limiting the use of bone grafts.

To this end, the invention relates to a one-piece healing element, characterized in that it comprises:

an implant part suitable for attachment to a dental implant, at least one lower part of which is oriented along a first axis,

- a coronary part intended for integration within a gum to form the gum during its healing, at least one upper part of which extends generally along a second axis,

and characterized in that the first axis and the second axis form a first non-zero angle.

The coronary part may include a lateral surface intended for integration within a gum to form the gum when it heals, and a terminal surface at its upper end, part of the lateral surface and of the terminal surface forming an emerging surface, intended to remain outside the gum, which is asymmetrical with respect to at least one median plane to present an anatomical shape, and / or this emerging surface comprising a single plane of symmetry to present an anatomical shape. Parts of the emerging surface of the healing element intended respectively for positioning oriented inward and outward of the mouth may have a different shape. A cross section perpendicular to the second axis of the lateral surface of the coronary part or a projection on a plane parallel to a transverse plane perpendicular to the second axis of the emerging surface of the coronary part can have:

- a substantially trapezoidal shape or a substantially polygonal, or triangular, or square, or rectangular, or ovoid, or a substantially polygonal shape with rounded angles; and or

- a part intended for a positioning oriented towards the outside of the mouth of larger dimension than a part intended for a positioning oriented towards the inside.

The emerging surface of the healing element may have an identifiable three-dimensional shape, forming a digital impression taking part, automatically allowing its recognition, its positioning, and / or its orientation and indirectly the positioning and orientation of a the implant (60), without marker.

The healing element can have the following characteristics:

- At least part of the lateral surface of the coronary part, in particular at the level of an upper part such as an emerging surface, is formed by a set of parallel generatrices, and the second axis is parallel to this set of generatrices; or - at least part of the lateral surface of the coronary part, in particular at the level of an upper part such as an emerging surface, is inscribed in a cylinder with circular section closest to said part, and the second axis corresponding to the axis of this cylinder.

The healing element may include a conical surface capable of cooperating with a conical portion of a screw head to seal an interface between a screw and the healing element, and / or may comprise a frustoconical portion capable of cooperating with a conical bearing surface of the implant to seal an interface between the implant and the healing element and to reduce to zero any play in translation between the healing element and the implant. The healing element may include an anti-rotational element, in particular a portion of hexagonal section, to cooperate with an anti-rotational element of an implant, in particular an opening of hexagonal section, and guarantee a fixing of the healing element. without rotation around the implant.

The healing element can be manufactured from a polymer material, in particular from a “PEEK” material or from metal, zirconia or titanium and / or can be manufactured by machining and / or by molding and / or by addition of material.

The central opening may locally include a widening dimensioned to allow the pivoting of a screw towards an orientation parallel to the first axis and / or to receive a male connection element of a prosthetic element, in particular a pillar, a temporary prosthesis support, a cap, or an impression-taking element.

The healing element may comprise a connecting device arranged in the second section of the central opening in the coronary part capable of receiving the removable fixing of a pillar, of a temporary prosthesis support, of a cap, or an impression taking element.

The angle formed between the first axis and the second axis can be between 5 and 30 degrees or is greater than or equal to 10 degrees.

The healing element may include a central opening extending over its entire length, suitable for the passage of a screw and / or a tool such as a screwdriver for screwing a screw into an implant, the opening central comprising an outlet at the lower end of the implant part, intended for cooperation with an implant, and the first axis being oriented parallel to the axis of the outlet. The central opening may include an entrance at the upper end of the coronary part, the entrance being substantially oriented along a third axis, and the second axis may be parallel to the third axis, or the second axis and the third axis may have a second non-zero angle.

The invention also relates to a dental restoration assembly comprising a healing element as described above, an implant, a screw, and a cap, capable of closing the central opening for forming a terminal surface of the healing element continuous and without roughness.

The invention also relates to a dental restoration system, characterized in that it comprises a healing element as described above, a digital impression element, in particular a scanner, and at least one computer which processes the images. from digital impression taking for automatic recognition, based on the anatomical shape of the healing element and / or by the recognition of at least one marker, of the type of healing element used, from images of an emerging part of the healing element.

The invention also relates to a method of dental restoration, characterized in that it comprises a step of screwing in the mouth of a healing element as described above using a screw, by passing a tool, in particular a screwdriver, through the central opening of the healing element, so as to reach the screw and allow it to be screwed into an implant.

The dental restoration method can comprise a step of determining a positioning of a dental implant, integrated into a bone structure of an individual, from the identification and the positioning of a healing element as described above. , the healing element being fixed at one of its ends in the implant, the healing element comprising a lateral surface intended for integration within a gum to shape the gum during its healing , and a terminal surface, part of the lateral surface and of the terminal surface forming an emergent surface, intended to remain outside the gum, which is asymmetrical with respect to at least one median plane to present an anatomical shape. Brief description of the drawings

These objects, characteristics and advantages of the present invention will be explained in detail in the following description of two particular embodiments made without implied limitation in relation to the attached figures among which:

Figure 1 is a sectional view of a dental restoration assembly according to a first embodiment of the invention.

FIGS. 2A, 2B, 2C and 2D are respectively views of a right lateral side, a lingual side, a left lateral side and a vestibular side of the dental restoration assembly according to the first mode of production.

Figure 2E is a perspective view of the dental restoration assembly according to the first embodiment.

FIGS. 3A, 3B, 3C and 3D are respectively views of the right lateral side, the lingual side, the left lateral side and the vestibular side of a healing element of the dental restoration assembly according to the first embodiment.

FIGS. 4A, 4B, 4C, 4D and 4E are respectively views of a right lateral side, a lingual side, a left lateral side, a side vestibular, and in perspective of the dental restoration assembly according to a second embodiment.

FIGS. 5A, 5B, 5C and 5D are respectively views of the right lateral side, of the lingual side, of the left lateral side and of the vestibular side of a healing element of the dental restoration assembly according to the second embodiment.

Figures 6A, 6B, 6C and 6D are respectively a side view, a sectional side view, a sectional and exploded side view, and an exploded side view of the dental restoration assembly according to the second embodiment.

Figures 7A to 7D are schematic views of steps in a dental restoration process.

FIGS. 8A to 8L are radiographs of the teeth superimposed by dental restoration sets in order to illustrate the advantages of a dental restoration set according to the invention compared to a standard dental restoration set.

FIGS. 9A, 9B, 9C and 9D are respectively a side view, a sectional side view, a sectional and exploded side view, and an exploded side view of the dental restoration assembly according to the second embodiment equipped with an impression transfer support. Figure 9E is a perspective view of a healing element according to an alternative embodiment of the invention.

Figure 10A is a side view of an implant equipped with a dental restorative abutment and a top prosthesis.

FIG. 10B is a side view of the implant equipped with the dental restoration abutment and the summit prosthesis superimposed on a view of the implant equipped with a healing element according to one embodiment.

Description of an embodiment

In the description which follows, the same references will be used for all the variant embodiments to designate the same components, or even their equivalents, so as not to burden the text and to facilitate its reading.

In addition, we will conventionally choose a reference point along an axis defined with reference to a longitudinal axis of an implant, the adjective "upper" designating the side of the implant intended for orientation towards the gum and the adjective "lower Designating the opposite side. The same "lower" and "upper" adjectives will be used for all the components forming a dental restoration, with reference to the position they are intended to occupy when they are linked to an implant.

FIG. 1 illustrates a dental restoration assembly 1 comprising a healing element 10 according to a first embodiment of the invention, as well as a screw 50 and an implant 60, the latter being integrated in a bone structure 2 of a patient, the bone structure being covered with gum 3.

Such a dental restoration set participates in the implementation of a dental restoration process which may include a first phase then a second phase.

During the first phase, called the healing phase, one or more implant (s) are integrated into the patient's bone structure by osseointegration. During this first phase, a particular healing element is used, as will be detailed later. The healing element 10, which could also be called the "healing cap", can be fixed on the implant for the time necessary for the healing of the gum and the osseointegration of the implant. The healing element is therefore an element used temporarily. It covers the implant while allowing scarring of the gum. It can prevent the implant from being covered by the gum while it heals. It can have, in addition to its healing aid function, an aesthetic function by filling the hole formed by the removed tooth, the time of healing. The healing element may not be intended to form a prosthesis useful for chewing so as not to transmit stress to the implant during its osseointegration. For this purpose, it can for example be provided lower than the neighboring teeth. The design of the healing element can be adapted for temporary use, usually on the order of a few months. The healing element can then be easily detached from the implant to which it is attached.

The second phase is a restoration phase as such. During the second phase, a final prosthesis is placed on the implant (s) via a restoration abutment. The final prosthesis therefore replaces the healing element. The final prosthesis can be made to measure to integrate perfectly with the patient's dentition. On the contrary, the healing element can be a standard element or at least available quickly. In particular, the healing element does not necessarily have to be custom-made by a dental technician.

With reference to FIGS. 1, 2A, 2B, 2C, 2D and 2E, the implant 60 comprises an overall envelope of cylindrical or frustoconical shape and a longitudinal axis L. It advantageously has a symmetry of revolution with respect to this longitudinal axis, which forms an axis of revolution. The implant 60 comprises an anchoring means 61 in the bone structure of the patient. The implant includes an opening on the side of its upper end inside which is a connection device 64 with the healing element 10. The connection device 64 comprises a threaded opening 65, an opening of hexagonal section 66 in the extension of the threaded opening 65 and a conical bearing 67 opening onto an upper face of the implant. The threaded opening 65, the hexagonal section opening 66 and the conical bearing 67 are adjacent, coaxial with the longitudinal axis L and arranged so that the threaded opening 65 is on the lower side of the implant 60, the bearing conical 67 is on the upper side of the implant 60 and the hexagonal section opening 66 is in an intermediate position between the threaded opening 65 and the conical bearing 67. FIGS. 3A, 3B, 3C and 3D illustrate a healing element 10 according to a first embodiment. The healing element 10 is in one piece, that is to say that it consists of a single piece and preferably from a single material. As illustrated in FIG. 3A, the healing element 10 comprises an upper part, called the coronary part 1 1, intended to be in contact with the gum 3 of the patient, in other words, intended for integration within a gum for shape the gum when it heals. The healing element 10 also includes a lower part, called the implant part 12, intended to be introduced into the opening of the implant to cooperate with the connection device 64 and allow the healing element 10 to be fixed on the 'implant 60.

The healing element comprises a central opening 13, passing through and intended to receive the screw 50 screwed into the threaded opening 65 of the implant. The central opening therefore forms a well for the screw 50. The healing element is intended to be fixed to the implant by means of the screw 50. The central opening 13 comprises an outlet 14 at the level of the part implant 12 substantially oriented in the direction of a first axis A1. In other words, the outlet 14 corresponds to the lower mouth of the central opening 13, the lower part of which is substantially cylindrical and oriented along the first axis A1. The implant part 12 being intended for a connection with an implant 60, this first axis A1 is intended for alignment with the longitudinal axis L of an implant. Thus, the implant part 12 of the healing element, in particular at least its lower part, is generally oriented along the first axis A1. The central opening 13 further comprises an inlet 15 in the upper part of the healing element, provided for the insertion of the screw 50. The coronal part 1 1 extends generally in the direction of a second axis A2. In other words, the external shape of the coronary part 11 develops, or deploys, from a border between the implant part and the coronary part, in the direction of the second axis A2. Depending on the particular geometry of the coronary part, the second axis A2 can be defined in different ways.

First of all, all or part of the lateral surface 22 of the coronal part 11, in particular at the level of its upper part, is advantageously defined by a set of generators G, parallel to each other. The second axis A2 is in this case defined with reference to the orientation of this set of generators G, that is to say as an axis parallel to these generators G. In fact, as appears for example in FIGS. 2A in 3D, the coronal part 1 1 comprises a lateral surface defined by a set of parallel generatrices G.

As a variant, in the case of a more complex lateral surface 22 of the coronal part 1 1, not defined by parallel generatrices, it is possible to refer to the cylinder with circular section closest to the coronal part, particularly the upper part of the coronary part, in which it is inscribed. The second axis A2 thus corresponds to the axis of this nearest cylinder. According to another approach, in the case where the cross sections, perpendicular to the second axis A2, of the coronary part, at least in its upper part, have a center, this second axis A2 comprises these different centers. According to the invention, the first axis A1 and the second axis A2 are not aligned, that is to say that they are not parallel. In other words, the first axis A1 and the second axis A2 form a first non-zero angle a. Thus, the healing element is angled, its two implant and coronary parts having a different orientation.

Advantageously, the angle a between the first axis A1 and the second axis A2 is between 5 and 30 degrees. In the first embodiment illustrated in Figures 1 to 3D, the angle a is equal to 10 degrees. Such a value makes it possible to keep an insertion and an easy pivoting of the screw 50 inside the central opening 13. When the healing element is fixed on the implant 60, the first axis A1 is coincident with the longitudinal axis L of the implant. This assembly is notably illustrated in FIG. 1 and in FIG. 2A. This assembly is obtained by screwing the screw 50 into the implant 60, through the central opening 13 of the healing element 10, for example by means of a screwdriver.

Note, in this first embodiment, the second axis A2 also corresponds to the orientation of the inlet 15 of the central opening 13, which is substantially arranged in the central part of the terminal surface 21 which forms the upper surface of the healing element. The inlet 15 corresponds to the upper mouth of the central opening 13, the upper part of which is substantially cylindrical and oriented along a third axis A3. In this first embodiment, the second axis A2 can be defined as an axis parallel to this third axis A3. In other words, in this particular configuration of input 15, the two axes A2 and A3 are parallel, and the second axis A2 can be defined from the third axis A3 of the inlet 15 the central opening.

In FIG. 1, it can be seen that the central opening 13 of the healing element 10 comprises a first section 1 6 at the height of the implant part 12, oriented along the first axis A1 and a second section 17 at the height of the part coronary 1 1 oriented along the third axis A3. The first section extends from exit 14 to the second section with which it communicates. Likewise, the second section extends from entrance 15 to the first section. The central opening forms a bend 18 or a curved portion at the interface between the first section and the second section. The elbow 18 is positioned substantially at the height of the limit between the implant part 12 and the coronary part 1 1 of the healing element.

The second section 17 comprises a set of sections of circular shape and centered on the third axis A3. By traversing the second section 17 from the inlet 15 in the direction of the elbow 18, it is noted that it consists of a first section 17A of frustoconical shape, followed by a second section 17B of cylindrical shape, followed by a widening 17C, followed by a third section 17D of cylindrical shape. This third section 17D communicates with the elbow 18. The widening 17C is a section of the second section whose diameter is larger than the diameter of the sections positioned on either side of this widening. It allows the screw 50 to pivot inside the healing element when it is put in place. The screw 50 can therefore pivot from an orientation parallel to the third axis A3 to an orientation parallel to the first axis A1. As a reminder, in this first embodiment, the second axis A2 and the third axis A3 are aligned, which will not be the case of the second embodiment described below.

Similarly, the first section 1 6 comprises a set of sections of circular shape and centered on the first axis A1. By traversing the first section 16 from the elbow 18 in the direction of the outlet 14, it is noted that it consists of a conical bearing 1 6A forming a first section of frustoconical shape, followed by a second section 1 6B of cylindrical shape . The conical bearing 16A is intended to cooperate with a conical portion (in other words frustoconical) of a screw head 51 of the screw 50, of complementary shape, so as to form a sealed interface.

The screw 50 comprises a screw head 51, a threaded part 52, and a cylindrical part 53. The cylindrical part 53, not threaded, is arranged between the threaded part 52 and the screw head 51. The threaded portion 52 is intended to collaborate with the threaded opening 65 of the implant to lock the healing element in position. The cylindrical portion 43 of the screw is intended to be positioned at the level of the second section 1 6B of the first section 1 6 of the central opening 13 of the healing element. The healing element and the screw can be delivered preassembled which reduces the amount of handling for the dentist.

The healing element 10 comprises at its lower end and on an outer periphery a portion of hexagonal section 19, able to cooperate with the opening of hexagonal section 66 of the implant. The interface thus formed makes it possible to guarantee a fixing of the healing element 10 with fixed orientation, without rotation of the healing element around the implant 60. Note, the cooperation of the hexagonal sections allows consider six different positions of the same healing element relative to the implant. These positions are distinguished by rotations of 60 degrees from the healing element around the first axis A1. The dentist will be able to identify the orientation that best suits the patient's anatomy. The hexagonal section portion 19 and the hexagonal section opening 66 are anti-rotational elements which could be replaced by any other equivalent anti-rotational elements. As a variant of a hexagonal section, the healing element could comprise any other pattern capable of cooperating with an implant having a complementary pattern to perform an anti-rotation function. This pattern could for example include a polygon with more than six sides so as to offer choices of orientation of the healing element distinguished from each other by an angle rotation less than 60 degrees. This pattern could also include a set of slots capable of cooperating with complementary slots arranged on the implant.

The healing element thus comprises an implant fixing device at its lower end. In addition, the healing element also comprises on the outer periphery of its implant part 12 a frustoconical portion 20 or substantially frustoconical, able to cooperate with the conical surface 67 of the implant to form a sealed interface between the implant and the healing element. The conical bearing 67 and the frustoconical portion 20 have a sealing cone function and also a unique positioning function of the healing element relative to the implant. Indeed, the assembly of the conical bearing 67 with the frustoconical portion 20, reduces to zero any play in translation between the healing element and the implant, after tightening the screw 40. In addition, as a rotation of the healing element relative to the implant is impossible thanks to the interface formed by the hexagonal section portion 19 and the hexagonal section opening 66, the connection between the healing element 10 and the implant 60 is a particularly rigid connection.

With reference to FIG. 2E, the dental restoration assembly 1 comprises a cap 80 capable of closing the entry 15. This cap is also visible in FIGS. 6B, 6C and 6D illustrating a second embodiment of the invention . The cap 80 comprises a frustoconical head 81, a cylindrical body 82 and a male connection element 83. The frustoconical head 81 cooperates with the first frustoconical section 17 A of the healing element to form a sealed interface between the cap 80 and the healing element, at its upper surface. The cylindrical body extends along the second section 17B of the healing element when the cap is in place. The male connecting element 83 cooperates with the enlargement 17C to form a clipping-type connection. The cap 80 also includes a blind and threaded opening 84 on its upper face. This opening 84 provides a grip for a tool specifically adapted for removing the cap by traction. Note, this opening 84 is of small size so that a limited volume of foreign bodies could lodge there. This opening 84 can also be filled with a suitable sealing paste, or closed with a second cap during the healing period to form an upper surface of the continuous healing element, without roughness.

The existing implants may have different shapes and in particular devices for connection to different dental restoration elements. There can be as many elements of dental restoration different than different connection devices, in order to be able to have, for each existing implant, a healing element provided with a connection device which is adapted to it. The healing element 10 has the function of being housed within the incised gum, after fixation of an implant. In this configuration, the implant 60 is secured to the bone structure 2. It does not or only slightly emerge from the bone part in the gum 3. The healing element 10 is fixed to the implant 60 so that the gum 63 is almost exclusively in contact with the healing element 10. The healing element may comprise at least one plane substantially perpendicular to the second axis A2 defining a 360 ° contour of the healing element which is fully in contact with the gums. More generally, the healing element may include a line extending 360 ° around the healing element, on the lateral surface 22 of the coronal part 1 1, which is in full contact with the gum. A significant part of the height of the healing element, in particular of its lateral surface 22, is more advantageously in contact with the gum. At least half of its height can thus advantageously be in contact with the gum, on at least one axis substantially parallel to the second axis A2 along the lateral surface of the healing element. The healing element temporarily participates in the restoration process, fulfilling the healing function of the gum. It can also participate in the smooth production of the final prosthesis, as will be detailed later.

As mentioned above, the coronal part 11 of the healing element comprises an end surface 21 through which opens the entrance 15 of the central opening 13 and a lateral surface 22 around which the gum 3 is intended to heal. The lateral surface 22 is chosen to best correspond to the oral environment of the patient. The terminal surface 21 of the healing element is intended to remain visible above the gingival surface 4 of the gum 3, since the gum remains in full contact with the lateral surface 22 of the healing element. The terminal surface 21 is oriented substantially perpendicular to the second axis A2. Thus, when the healing element is fixed to the implant in the patient's mouth, the terminal surface 21 is inclined relative to the axis of the implant. Advantageously, the dentist will be able to orient the healing element so that the terminal surface 21 is turned towards the inside of the mouth at an inclination corresponding to the angle a. Such an inclination makes it possible to hide, or at least make the central opening 13 or the screw head 51 less visible. The upper part of the lateral surface 22 and the terminal surface 21 therefore form an emerging surface 23 of the healing element. This emerging surface is illustrated in particular in FIG. 1. With reference to FIG. 2E, it can be seen that the shape of the terminal surface 21 of the healing element has an asymmetrical shape. The lingual side CL designates the part of the lateral surface 22 oriented towards the inside of the mouth, that is to say towards the tongue of the patient. Similarly, the vestibular side CV designates the part of the lateral surface 22 oriented towards the outside of the mouth, that is to say towards the patient's lip. The vestibular side of the healing element is wider than the lingual side. The terminal surface 21 may have substantially the shape of a trapezoid. Therefore, the inner part (lingual CL) and the part outer (vestibular CV) of the healing element have a different shape.

The shape of the healing element has rounded corners and curved sides, to ensure that it does not hit the gum. In addition, the terminal surface 21 of each healing element has, with the exception of the central opening 13, a continuous surface, without reliefs, and / or without hollow part, and / or without groove, and / or without stops , and / or without roughness. This surface is convex. This uneven geometry is favorable for oral hygiene, reduces the accumulation of food and the deposition of dental plaque.

Thanks to the use of the cap 80, the terminal surface 21 is substantially continuous, even at the level of the inlet 15. Thus, this terminal surface closed by the cap 80 has substantially the property of a continuous surface, without reliefs, and / or without hollow part, and / or without groove, and / or without stop, and / or without roughness. Such a cap guarantees good oral hygiene, since the healing element is intended to remain in the mouth during the healing phase, being alone in contact with the gum and unprotected from oral attack.

In addition, the cross section of a healing element at its lateral surface 22, that is to say the section along a plane substantially perpendicular to the second axis A2, could take any other anatomical form, in particular it could s '' approach any polygon, like a polygon with three, four, five or six sides. As a variant, the angles of these polygons could be so rounded that the overall shape would approach an oblong shape, or even of section ovoid, or any other form further from a polygon. This lateral surface section 22 and the terminal surface 21 (and / or its projection on a plane perpendicular to the second axis A2) finally have an identical or similar shape, since they come in continuity from one another.

According to the embodiment, the geometry of the visible emerging surface of the healing element on the inside of the mouth differs from the geometry on the outside, to take account of the curvature of the gum and / or the natural shape of the teeth. We can define a justogingival plan PJ as the plan in which the gum extends at the level of the emergence of the teeth. The justogingival plan is in particular shown by way of example in FIGS. 8A to 8L. The shape of the emerging surface of the healing element is asymmetrical with respect to at least one median plane, perpendicular to the justogingival plane and passing through a center C of the terminal surface 21. In particular, the healing element is asymmetrical with respect to the median plane PM illustrated in FIGS. 2E and 4E. The above mentioned mid-plane PM delimits the lingual side of the vestibular side of the healing element.

On the one hand, the asymmetry can be characterized by a height along the second axis A2 of the coronary part of the healing element on the lingual side, greater than the height of the healing element on the vestibular side. Such a difference in height Ah is particularly visible in FIG. 3C or in FIG. 5C. Furthermore, by considering the projection of the coronary part, particularly its terminal and / or emergent part, of the healing element on a transverse plane P, perpendicular to the second axis A2, the asymmetry can be characterized by a shape that is not circular of the outline of this projection. In other words, this section has at least one axis passing through the center of the section and defining an axis of non-symmetry of the section. According to the embodiments presented, the coronal part of the healing element comprises a single plane of symmetry PS (see FIGS. 2E and 4E). Thus, each healing element is equally well suited for integration in the left or in the right part of a patient's dentition. As a variant, a healing element could comprise no plane of symmetry and be specifically adapted either to the right side or to the left side of the patient's dentition.

Finally, the emerging surface of a healing element can take any identifiable three-dimensional shape, making it possible to recognize the healing element used and possibly to know its orientation, to fulfill a second function which will be detailed later in addition to allowing the healing of the gum in an anatomical form. The healing element can be made of plastic material, compatible with medical use, and of pink, white or cream color. In particular, the healing element can be made from a polymeric material, in particular from a “PEEK” material. Alternatively, it can be made of metal, for example titanium, or it can be made of zirconia. Indeed, this healing element 10 can be made of titanium with a surface treatment made from zirconia nitride in order in particular to improve the visibility of this element 10 by oral scanners, while being biocompatible. The healing element can be manufactured by machining and / or by molding and / or by addition of material, in other words by 3D printing.

The use of dental restorative elements therefore makes it possible to promote ideal healing of the gum in the context of a dental restoration process due to its geometry designed in phase with the oral anatomy. As a note, this healing element can alternatively be totally subgingival and invisible, then made visible by intervention on the gum. In this case, the extreme part of the healing element will always be incorrectly called the emerging part.

The shape of the coronary part of the healing element is specifically chosen to promote the healing of the gum, according to an anatomical shape that best corresponds to the tooth to be replaced and therefore also to the future summit prosthesis intended to occupy this oral space. .

Advantageously, the dentist can have a variety of ready-to-use dental restorative elements. The dental restorative elements of the set are distinguished by different sizes and with different angle values a. The angle a is preferably greater than or equal to 10 °. The dentist will be able to select the healing element best suited to the patient's oral geometry. Staining of the screw or cap can quickly identify the size and / or angle a of a given healing element. Thus, the dialogue between dentists and prosthetists can be simplified. We will now describe the second embodiment of the dental restoration assembly with reference to FIGS. 4A to 4E and 5A to 5E, detailing the differences with the first embodiment. According to the second embodiment, the second axis A2, in particular corresponding to all the generators G in this embodiment, the first axis A1, along which the outlet 14 is oriented, and the third axis A3, along which is oriented the entrance 15, are all three distinct, that is to say that they are not parallel to each other. The angle a designates the angle formed between the second axis A2 and the first axis A1. A second angle b is defined, as the angle formed between the second axis A2 and the third axis A3. The angle b can be for example between 0 degrees and 30 degrees. Note the first embodiment corresponds to a healing element whose angle b is zero. According to the second embodiment, the angle b is equal to approximately 10 degrees and the angle a is equal to approximately 20 degrees. Advantageously, the angle b can be formed in the same direction as the angle a, in other words in the same plane as the angle a, so that the angle formed between the first axis A1 and the third axis A3 can be obtained from the two angles a and b. Thus, the second embodiment of the healing element comprises an angle formed between the first axis A1 and the third axis A3 equal to 10 degrees. Advantageously, the range of ready-to-use dental restoration elements is supplemented by dental restoration elements with different angle values.

FIGS. 7A to 7C schematically illustrate a step of choosing a particular healing element during a dental restoration process. Initially as illustrated in FIG. 7A, the implant 60 is fixed to the bone structure 2 of the patient. Then, the dentist chooses from the panoply of elements of dental restoration at his disposal the element of healing best suited to the shape of the tooth to be replaced. It can use a healing element according to the invention as illustrated in FIG. 7B or a healing element according to the state of the art as illustrated in FIG. 7C. It is observed that for a healing element according to the state of the art, as illustrated in FIG. 7C, the central opening is oriented on the vestibular side. That is to say, the central opening opens onto a face of the tooth facing the outside of the mouth. The central opening is therefore easily visible. On the other hand, for a healing element according to the invention, as illustrated in FIG. 7B, the central opening 13 is oriented on the lingual side. The central opening opens onto a face of the tooth facing the inside of the mouth and is therefore less easily visible. It is therefore preferable to choose a healing element according to the invention to optimize the aesthetics of the patient's dentition. Figure 7D illustrates the final prosthesis at the end of the dental restoration process. The final prosthesis can be fixed to the implant by means of a screw passing through a screw well of the final prosthesis. This screw well can be oriented parallel to the second axis A2.

FIGS. 8A to 8L illustrate, by way of example, twelve practical cases in which a healing element according to the invention is advantageously used. More particularly, in the cases illustrated in FIGS. 8B, 8C, 8E, 8G, and 8J, a healing element was used according to the first embodiment of the invention. In the cases illustrated in FIGS. 8A, 8D, 8F, 8H, 81, 8K and 8L, a healing element was used according to the second embodiment of the invention. For each figure, we illustrates, with an overlay of an x-ray image, the replacement of a standard healing element (visible on the left in each figure) by a healing element according to the invention (visible on the right in each figure). It can be seen that the terminal surface 21 and the inlet 15 are oriented towards the inside of the mouth. This prevents the cap 80 from being visible from the outside, which improves the aesthetics of the patient. In addition, the use of a healing element according to the invention promotes the formation or healing of the gum in an anatomical shape, which further improves aesthetics. It is noted in particular that the volume of gum on the vestibular side is greater when using a healing element according to the invention. Furthermore, the emergence axis of the coronary part, that is to say the orientation of the second axis A2, corresponds better to the future tooth. Indeed, as can be seen by observing the position of the original tooth, an inclination towards the inside of the mouth of the coronary part makes it possible to better reproduce the natural inclination of a tooth. The final prosthesis, replacing the healing element at the end of the healing phase, comprises a screw well able to cooperate with a screw for fixing it to the implant. The screw well of the final prosthesis is also oriented parallel to the second axis A2 to reproduce the natural inclination of the tooth.

In addition to the advantages described above, the healing element allows the implementation of an advantageous restoration method, and a method of manufacturing a dental prosthesis and a permanent abutment, with minimal trauma to the gum. . Indeed, it is possible to obtain a digital or physical imprint of the area to be restored without removing the healing element in the mouth, therefore without hitting the gum. So, in addition to its first healing function, detailed above, the healing element fulfills a second function during the restoration process, allowing the advantageous definition of the shape of the restoration abutment and / or of the prosthesis before its removal. This function is complementary to its first healing function since it makes it possible not to traumatize the gum after its healing according to an advantageous anatomical shape chosen.

For this, at the end of the healing phase of the dental restoration process, a practitioner can take a digital impression of the patient's mouth, without removing the healing element. The scanning data, obtained by any device such as an oral scanner for example, is automatically transmitted to a computer with dental restoration software. This software has a human-machine interface, by which an operator can indicate the model of healing element he has used, or more generally the reference of the healing element, and possibly the implant used.

In order to identify the healing element model used, a first approach may be to form dental restorative elements or different colored screws or caps for different healing element models.

A second approach consists in placing any indicator on the emerging surface of the healing element to indicate the model of healing element, this indicator can be composed of numbers and / or letters and / or any symbol and / or colors and / or laser markings and / or one or more barcodes and / or datamatrix codes and / or any identification code.

According to a third approach, the healing element model may have been previously saved in a database associated with the patient. The dentist then only has to consult this database to identify the model used.

Finally, according to a fourth approach, the software may be able to automatically identify the model of healing element used by comparing a scan of the emerging surface obtained with the oral scanner with a database comprising a set of scans of the different models. elements of dental restoration that the dentist may have attached to the patient's implant. The software then determines which model of healing element has a shape coinciding with the imprint of the emerging surface detected by the oral scanner. The asymmetrical anatomical shape of the emerging part and the terminal surface of the healing element makes it automatically identifiable in this digital operation. The approaches previously described by way of example can also be combined with one another in order to make the identification of the healing element more reliable.

From the scan data, software automatically determines the position of the healing element. Indeed, the anatomical shape of the emerging surface 23 is recognizable to form a digital impression taking part. More precisely, the software makes the emerging surface of the dental element coincide as obtained by the oral scanner with a digitization of the complete healing element previously identified, this digitization being available in a library in the form of a database stored in an electronic memory which it can consult. The dentist or an operator can possibly assist the software in the correct superimposition of the scanning of the emerging surface obtained by the oral scanner with the scanning of the identified healing element model, by capturing on an image obtained by the scanning step. mentioned above and presented to the operator on a screen of a man-machine interface one or more points of the emerging surface. Then, by geometric construction, the software automatically determines the position of the fixed implant in a unique position relative to the healing element. Thanks to such software, the dentist can thus determine the position, and in particular the axis of the implant, without having to view it directly.

When the restoration software has precisely repositioned the positioning of the hidden implant, it deduces from this knowledge the final geometry of a final prosthesis which must be fixed to the implant and occupy the entire gingival volume defined by the element of healing. This final prosthesis can then be fixed to the implant either directly or via a dental restoration abutment fixed to the implant, in known manner.

As a note, this restoration process can be done completely digitally, therefore virtually, or include construction phases of a plastic or plaster model. In the latter case, a physical impression, for example silicone, can be made, a plaster can be poured into the impression to create the master model, it is to say a replica of the dental arch to be restored, which is then scanned in the laboratory to reconstruct a digital image.

As appears from the description above, the last phase of the restoration process therefore relies on a restoration device, which comprises a central processing and control unit, here comprising at least one microprocessor, linked to an electronic memory, on which software is executed allowing the implementation of all or part of the steps of the restoration process described above. This central unit is linked by a communication device to a module for obtaining digital data representing all or part of a dentition of a patient, which can consist of a device such as an oral scanner. It is also linked to a man-machine interface, comprising for example a screen and / or a keyboard, to allow exchanges with an operator, as explained above. The central unit then performs all the necessary processing, calculations and others, by software means. Finally, it is able to generate and transmit manufacturing orders to a device for manufacturing a restoration and / or prosthesis abutment. It can also be linked by a second communication device to a manufacturing device such as a machine tool.

As illustrated in FIGS. 9A to 9D, the healing element can also be used for the temporary or permanent fixation of a prosthetic element or of a dental restoration tool. As it appears in the specific example of these figures, the prosthetic element can for example be a temporary abutment or a support 30 around which a summit prosthesis, preferably temporary and optionally final, can be fixed in order to improve the aesthetics and / or patient comfort. The tool dental restoration could for example be a traditional impression element, which makes it possible to record by traditional impression in an impression material such as an appropriate paste, an impression of the buccal space at the level of the implant concerned with dental restoration. It is therefore an alternative to the digital impression taken previously described. The prosthesis support 30 has a generally cylindrical shape and can be locally truncated so as to be compatible with the angled shape of the healing element 10. Advantageously, the support 30 comprises a male connecting element 31 able to cooperate with the enlargement 17C arranged inside the central opening 13. The enlargement 17C therefore also has the function of a prosthesis support 30, provisional or not, and / or of an impression transfer element. These connecting elements can allow a clipping-type connection, or any other mechanical connection. In addition, the support 30 can be fitted with circumferential ridges 32 improving the adhesion of the summit prosthesis to the support 30. In order to guarantee a unique orientation of the support 30 relative to the healing element 10, an anti-rotational device 24, visible in FIG. 9E, can be arranged in the second section 17 of the central opening 13. The anti-rotational element 24 can be in the form of a groove parallel to the third axis A3 and practiced on all or part of the height of the second portion 17 of the central opening 13. Naturally, as a variant, any other removable connection device can be arranged at the second section 17 of the central opening 13 within the coronal part 1 1 .

After healing, an angled dental restoration pillar 40 is fixed on the implant to support a summit prosthesis 70, thus finalizing the dental restoration, illustrated in Figure 10A. As a note, this elbow advantageously has an angulation identical to or close to the angulation of the healing element used for healing. As illustrated in FIG. 10B, the lower shape of the top prosthesis 70 within the gum corresponds to that of the healing element 10 used for healing: thanks to this approach, the prosthesis takes place smoothly, ideally , in the anatomically shaped housing prepared by the healing phase. The prosthesis can easily be fixed to the implant by means of a screw passing through a screw well oriented on the lingual side. The final prosthesis is therefore particularly aesthetic since the screw well is invisible from the outside of the mouth.

Thanks to the invention, there is a healing element which minimizes the trauma of the patient during the restoration process because it is not useful to remove it to make an impression of the underlying implant in order to manufacture the final prosthesis. The healing element can even be kept during the installation phase of the final prosthesis, which further reduces trauma for the patient. Thanks to its anatomical shape, the gum heals according to its natural shape. The gum is not deformed during the fitting of the final prosthesis. In addition, the installation of a healing element is particularly simple because it consists of a single piece screwed into the implant. Finally, the aesthetic appearance of the patient is optimized from the healing phase because the healing element has a coronary part whose orientation respects the natural orientation of the teeth and their shape. In addition, this orientation makes it possible to hide the well of the screw used for fixing. This particular curvature of the restoration element, then of the possible final restoration pillar, allow the formation of a prosthesis 70 arranged around a lower opening forming a connecting means intended to cooperate with said pillar, since it is fixed in the correct final orientation thanks to the prior arrangement of the invention. This avoids, for example, trying to make up for an angle by means of an asymmetrical shape of a prosthesis, to the detriment of the mechanical rigidity and the aesthetic appearance of this prosthesis. In other words, the invention makes it possible to use a prosthesis of optimal shape, which automatically extends at the end of restoration overall in the direction defined by the second axis A2, not aligned with the longitudinal axis L of the implant.

Claims

1. One-piece healing element (10), characterized in that it comprises:

an implant part (12) suitable for attachment to a dental implant (60), at least one lower part of which is oriented along a first axis (A1),

- a coronary part (1 1) intended for integration within a gum (3) to shape the gum (3) during its healing, at least one upper part of which extends generally along a second axis ( A2),

and characterized in that the first axis (A1) and the second axis (A2) form a first non-zero angle (a).

2. Healing element (10) according to the preceding claim, characterized in that the coronal part (11) comprises a lateral surface (22) intended for integration within a gum (3) to shape the gum ( 3) during its healing, and a terminal surface (21) at its upper end, part of the lateral surface (22) and of the terminal surface (21) forming an emerging surface (23), intended to remain out of the gum (3), which is asymmetrical with respect to at least one median plane (PM) to present an anatomical shape, and / or in that this emerging surface (23) comprises a single plane of symmetry (PS) to present a shape anatomical.

3. Healing element (10) according to claim 2, characterized in that parts of the emerging surface (23) of the element healing (10) intended respectively for positioning oriented inward and outward of the mouth have a different shape.

4. Healing element (10) according to one of claims 2 or 3, characterized in that a transverse section perpendicular to the second axis (A2) of the lateral surface (22) of the coronary part (1 1) or a projection on a plane parallel to a transverse plane perpendicular to the second axis (A2) of the emerging surface (23) of the coronal part (1 1) present:

5. Healing element (10) according to one of claims 2 to 4, characterized in that the emerging surface (23) of the healing element (10) has an identifiable three-dimensional shape, forming a grip portion of digital fingerprint, automatically allowing its recognition, its positioning, and / or its orientation and indirectly the positioning and orientation of an implant (60), without marker.

6. Healing element (10) according to one of the preceding claims, characterized in that: - At least part of the lateral surface (22) of the coronal part (11), in particular at the level of an upper part such as an emerging surface (23), is formed by a set of parallel generators (G), and in that the second axis (A2) is parallel to this set of generators; or

- at least part of the lateral surface (22) of the coronal part (11), in particular at the level of an upper part such as an emerging surface (23), is inscribed in a cylinder with circular section closest to said part , and in that the second axis (A2) corresponds to the axis of this cylinder.

7. Healing element (10) according to one of the preceding claims, characterized in that it comprises a conical surface (16A) capable of cooperating with a conical portion of a screw head (51) to seal an interface between a screw (50) and the healing element (10), and / or in that it comprises a frustoconical portion (20) capable of cooperating with a conical bearing (67) of the implant (60) to make seals an interface between the implant (60) and the healing element (10) and to reduce to zero any play in translation between the healing element (10) and the implant (60).

8. Healing element (10) according to one of the preceding claims, characterized in that it comprises an anti-rotational element, in particular a portion of hexagonal section (19), for cooperating with an anti-rotational element of an implant. (60), in particular an opening of hexagonal section (66), and guaranteeing a fixing of the healing element (10) without rotation around the implant (60).

9. Healing element (10) according to one of the preceding claims, characterized in that it is manufactured from a polymer material, in particular from a “PEEK” material or metal, zirconia or titanium and / or in that it is manufactured by machining and / or by molding and / or by addition of material.

10. Healing element (10) according to one of the preceding claims, characterized in that the central opening (13) locally includes an enlargement (17C) dimensioned to allow the pivoting of a screw (50) towards a parallel orientation to the first axis (A1) and / or to receive a male connection element (31, 83) of a prosthetic element, in particular of a pillar, of a support (30) of temporary prosthesis, of a cap (80 ), or an impression taking element.

11. healing element (10) according to one of the preceding claims, characterized in that it comprises a connecting device arranged in the second section (17) of the central opening (13) in the coronary part (1 1 ) capable of receiving the removable attachment of a pillar, a support (30) for a temporary prosthesis, a cap (80), or an impression taking element.

12. Healing element (10) according to one of the preceding claims, characterized in that the angle (a) formed between the first axis (A1) and the second axis (A2) is between 5 and 30 degrees or is greater than or equal to 10 degrees.

13. Healing element (10) according to one of the preceding claims, characterized in that it comprises a central opening

(13) extending over its entire length, suitable for the passage of a screw (50) and / or of a tool such as a screwdriver for screwing a screw (50) into an implant (60), l central opening (13) including an outlet (14) at the lower end of the implant part (12), intended for cooperation with an implant (60), and in that the first axis (A1) is oriented parallel to the axis of the outlet

(14).

14. Healing element (10) according to the preceding claim, characterized in that the central opening (13) comprises an inlet

(15) at the upper end of the coronary part (11), the inlet (15) being substantially oriented along a third axis (A3), and in that the second axis (A2) is parallel to the third axis

(A3), or the second axis (A2) and the third axis (A3) have a second angle (b) which is not zero.

15. dental restoration assembly (1), characterized in that it comprises a healing element (10) according to one of the preceding claims, an implant (60), a screw (50), and a cap (80) , able to close the central opening (13) to form a terminal surface (21) of the continuous healing element and without roughness.

16. dental restoration system, characterized in that it comprises a healing element (10) according to one of claims 1 to 14, a digital impression element, in particular a scanner, and at least one computer which uses the images from the digital impression taking for automatic recognition, on the basis of the anatomical shape of the healing element and / or by the recognition of at least one marker, of the type d healing element used, from images of an emerging part (23) of the healing element (10).

17. A method of dental restoration, characterized in that it comprises a step of screwing in the mouth of a healing element (10) according to one of claims 1 to 14 using a screw (50), by the passage of a tool, in particular a screwdriver, through the central opening (13) of the healing element (10), so as to reach the screw (50) and allow it to be screwed into an implant ( 60).

18. A method of dental restoration comprising a step of determining a positioning of a dental implant (60), integrated into a bone structure (62) of an individual, from the identification and positioning of an element healing (10) according to one of claims 1 to 14, the healing element (10) being fixed at one of its ends in the implant (60), the healing element (10) comprising a lateral surface (22) intended for integration within a gum (3) to shape the gum (3) during its healing, and a terminal surface (21), part of the lateral surface (22) and the terminal surface (21) forming an emerging surface (23), intended to remain outside the gum (3), which is asymmetrical with respect to at least one median plane (PM) to present an anatomical shape.